Case Study: Impact of Pelvic Floor Muscle and Yoga Training on Improving Three Women Uterine Prolapse

Abstract

Najwa Alfarra

Background: The incident of pelvic organ prolapses (POP) is 25% to greater than 90%. The symptoms of uterine prolapse can be extremely debilitating and impact patient’s quality of life [1]. This is a common problem in aging women. Main symptoms of POP are vaginal heaviness and discomfort, especially during sexual intercourse, in addition to urinary incontinence [2]. Physiotherapy is qualified as a conservative treatment to improve the tone and strength of the pelvic floor muscles through specific exercises and yoga techniques for the pelvic floor muscles to promote greater support for the pelvic viscera [3]. These techniques can improve the symptoms in mild and moderate cases and prevent the pelvic organs from slipping down further [4]. Aim of the Study: To explore the effectiveness of Yoga poses and Kegel exercises as a way of preventing and treating pelvic organ prolapse.

Case Description: Three women were referred to Physical Rehabilitation department by the Obstetrics and Gynecology physician. The first participant is 38 years old of age presented with a history of heaviness and discomfort in the vagina and pelvic pressure for one year. Urgency present sometimes, had one child. Had restricted physical activities such as standing up, walking, aerobic classes Second informant was a 45 years old had a history of six months heaviness at the lower abdominal area and discomfort in the vagina, had restricted physical activities such as walking, standing, jumping, running and aerobic classes and tensing up with anticipation of sex, unable to carry her baby, because the symptoms will get worse, and a companied with occasional stress incontinence, had three children, the last participant was 46 years old with a history of five years of stress incontinence and heaviness in the vagina, restricted her from doing housework and carrying her child. It requires her to manually push deeper the protruding organ and to empty the bowel easily, had chronic constipation, and had five children.

Management and Outcomes: Three participants received yoga training and Kegel exercises once per week for eight weeks in the clinic, followed by unsupervised (phone follow up )Kegel exercises and Yoga poses at home program for four weeks (12 sessions). After the completion of fourth weeks, they were seen at the clinic for reassessment and discharge. Outcomes as suggested by Hagen, et al, which included pre/post Pelvic Organ Prolapse-symptoms score (POP-ss), followed by prolapsed uterus symptoms, pelvic organ prolapse impact questionnaire, and the clinician’s observations.

Result: Significant effects in prolapsed uterus and urinary incontinence were reported following supported Yoga training and Kegel exercises program by two participants with significant improvement from the baseline to week 12. While third participant moderately improved in prolapsed uterus grade and almost cured stress incontinence.

Conclusion: Yoga poses and Kegel exercises program intended to address the pelvic floor and core muscles were found to have better outcomes in terms of decreasing prolapsed uterus and stress incontinence.

PDF